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olly

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There is still a debate whether primary lateral sclerosis (PLS) is a distinct pathological entity or whether it represents one end of a continuous spectrum of motor neuron disease (MND). In this report we present four PLS patients who have been observed from the time of symptom onset (1990-1999) through January 2007. All of them have had only upper motor neuron (UMN) signs and slow clinical progression. Three patients have been presented with spastic paraparesis. Spasticity was the main clinical feature in demonstrated cases with hyperactive deep tendon reflexes, clonus, and Babinski signs. One patient was presented with spastic dysarthria at the disease onset. Mean disease duration, measured from symptom onset to the present, was 11.5 years in our reported series. All four PLS patients had not developed lower motor neuron (LMN) signs during this time of observation. This prospective analysis of our PLS series is in agreement with data from other studies suggesting that pure PLS cases have a Motor Neurone Disease (MND) is one of the commonest neurodegenerative disorders of adulthood. MND characteristically presents with a combination of both upper and lower motor neurone features. Primary Lateral Sclerosis (PLS) is thought to be a variant of MND presenting with purely upper motor neurone signs. Debate continues over whether PLS constitutes a distinct pathological entity or whether it is part of the spectrum of motor neurone diseases that present as an upper motor neurone-predominant form of MND. We present a case of MND with purely upper motor neurone features and a prominent pain component. A pre-mortem diagnosis of PLS was made, however autopsy findings demonstrated both upper and lower motor neurone involvement. We believe these findings support the view that PLS is not a discrete pathological entity, but that it is a part of the range of motor neurone diseases that present with predominant but not exclusive upper motor neurone involvement. This case also highlights the feature that pain may be associated with MND even though it is not appreciated to have a sensory pathology.


this was taken from pub med/see my thread pls info, i have somewhere but can't find a article which states minor/non progressive lmn involvement can be had in pls
i'll try to find more
 

Geo

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I beleive in the Variants theory as many who have PLS or diagnosed that way ,have different symptoms .I personally have noticed many people who are in the forum have varying degrees of symptoms . I have no pain ,only stiffness and incoordination ,lack of good balance poor speech ,others have pain ,some start in the legs some start in the Bulbar region ,some have fast progression some dont some ,like yourself have Lower also .Being that the Brain is so compact and everything is so close ,something that is in one area could be partially in another .Like if you had a computor chip and something got in between the circuits in the chip, multiple things can happen. but the question of PLS versus ALS My cells are normal looking in a MRI my Brain is normal so Cell function is affected in me .not cell death .In ALS cell death is a fact and shows like ALZ .on an MRI as well as Atrophy of Muscle Tissue .I can grab your hand a squeeze it and you will know i still have strength . When you have Muscle Tissue Atrophy ,its because the Muscle is not stimulated by the Brain (no signal) In MG (Myasthenia Gravis ) you have a signal slowing or interuption caused by an Autoimmune system malfunction . Geo
 

Geo

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I forgot to add ,you notice who is conversing and who has nothing to add . You and i care enough that we engage in our thaughts .This is the way the answer will come ,not from not engaging in sharing of thaughts
Thanks For sharing Geo
 

olly

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geo

i have another excellent article iv'e found,
http://archneur.ama-assn.org
type in primary lateral sclerosis, on the first article(differences between)click full text.
very long and detailed,sorry i could'nt give full link but it was too long and did'nt work.
happy reading:-D
ps ----- i agree with there being varients,they now believe that in m.s
 

Geo

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I beleive 4-5 Variants in MS Relapsing Relenting, Chronic Progressive ,etc etc ? at one time we looked at it for me ,then after the second spinal tap that was a no ,everything was normal . i had a lady friend who was told since all clinical studies could show nothing she was crazy needed some rest . They have so many variants ,this is all because the circuitry is soo very close in the brain . And yes ignorants shows when a Doc. has so little education he resorts to "its in your head when nothing else fits .This is all they do when they cant find a label to put on you ."lets see does this one fit?""oh Good heres one we'll put on her "all about labels Geo
 

olly

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geo

once again your so right.neuro's "think" they know about the brain but science has only scratched the surface.
there are around 50billion neurons with a million billion synapses(connections),and with a overall firing rate of about 10million billion times per second.
the performance of even the most advanced of the neural-network computers........has about one ten-thousandth the mental capacity of a housefly, even the most powerful
supercomputor is equal to the nervous system of a snail.
as for the"fit" idea, that is exactly what has happened to me. my neuro has diagnosed'ed mnd but wont give definate diagnosed of pls or als, he sent my doc a letter saying he did'nt know which catagory to put me in!. so me and my doc's not happy with him.
my doc decided to refer me to mnd clinic so i can get a definate diagnosed.
from everything ive read (and believe me i've read hundreds of articles) it seems i may have umn dominant als, im still holding out for diagnosed of pls but the signs have not been good this past 12mths.so i can't wait for emg to know for sure,its a good job i'm not bothered about needles ,im clostraphobic so it's mri's i fear lol.
all the best to you.:-D
 

Geo

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I didnt think it would be bad until he stuck that long needle in my tongue ,being that i have Bulbar issues . Then he moves it around .First one under the chin second one in the end of the tongue .third time doc. says we already know you have bulbar so im not doing the tongue this time . They have open MRI,s . Needless to say this is why folks dont like having these done .Read something onMSN.com this morning about ALZ .good article Geo
 
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